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Vaccination, along with the improvement of social and hygienic living conditions, has played a key role in the prevention and control of infectious diseases due to its effectiveness, its favourable risk-benefit ratio and strong acceptance on the part of society and health policy makers. The further development of vaccination programs depends on the continual collection of valid data on the incidence of vaccine preventable diseases, immunisation rates, seroprevalence, vaccine related complications as well as on the evaluation of existing programs. The Protection against Infection Act (IfSG) in effect since January 1, 2001 has closed important gaps in the surveillance of vaccine preventable diseases and the implementation of vaccination programs in Germany. The data presented here show the decrease in the incidence of vaccine preventable diseases following implementation of vaccination and increasing vaccine coverage in Germany, underlining the effectiveness of vaccines as well as vaccination programs. The acceptance of vaccination is influenced by various factors that should be taken into account in the organization of vaccination programs. Measures shown to improve vaccination rates in international studies include the establishment of vaccine registries, reminder and recall systems, education of the public as well as health care workers, reimbursement of providers, improvement of access to providers and quality control measures. The deficits in Germany described here reveal further requirements for the organization of vaccination programs, for the improvement of awareness for the importance of vaccine coverage and for the achievement of health related goals.